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A.R.S. § 36-3231

Who Makes Medical Decisions When You Cannot: Surrogate Decision Makers

Verified April 4, 2026 • 57th Legislature, 1st Regular Session

If you become unable to make or communicate healthcare decisions and do not have a health care power of attorney, Arizona law establishes a priority list of people who can step in as your surrogate. The order is: spouse, adult children (majority of those available), parent, domestic partner, sibling, then close friend.

Title 36, LIVING WILLS AND HEALTH CARE DIRECTIVES

azleg.gov

The Priority List Arizona Follows

This is the statute that answers one of the most common questions in healthcare planning: "What happens if I do not have a health care power of attorney and I cannot speak for myself?" Arizona does not leave the answer to chance. The law sets a specific order of priority for who can make medical decisions on your behalf.

If the patient has a health care power of attorney that meets the requirements of section 36-3221, the patient's designated agent shall act as the patient's surrogate. However, if the court appoints a guardian for the express purpose of making health care treatment decisions, that guardian shall act as the patient's surrogate.

A.R.S. § 36-3231(A)

When neither a healthcare agent nor a court-appointed guardian exists, the law turns to family in this order: (1) your spouse (unless legally separated), (2) your adult children (a majority of those reasonably available must agree), (3) a parent, (4) your domestic partner (if unmarried), (5) a sibling, and (6) a close friend who is familiar with your healthcare wishes and willing to act in your best interest.

When No Surrogate Can Be Found

If none of the people on the list can be located, your attending physician may make healthcare decisions after consulting with an institutional ethics committee. If that is not possible, the physician may proceed after consulting with a second physician who agrees with the proposed course of treatment.

This fallback exists because medical decisions sometimes cannot wait. But it also illustrates exactly why having a health care power of attorney matters. Without one, a committee of strangers may end up directing your care. Naming an agent yourself takes that uncertainty off the table.

Mental Health Care Has Additional Protections

Arizona draws a careful line around mental health treatment. A surrogate who is not your designated agent or guardian generally cannot authorize admission to a psychiatric facility. The exception is narrow: if a mental health professional determines you are incapable and likely to suffer serious physical harm without immediate hospitalization, a surrogate can consent to emergency admission. But a petition for court-ordered evaluation or temporary guardianship must be filed within forty-eight hours, or you must be discharged.

36-3231. Surrogate decision makers; priorities; limitations A. If an adult patient is unable to make or communicate health care treatment decisions, a health care provider shall make a reasonable effort to locate and shall follow a health care directive. A health care provider shall also make a reasonable effort to consult with a surrogate. If the patient has a health care power of attorney that meets the requirements of section 36-3221, the patient's designated agent shall act as the patient's surrogate. However, if the court appoints a guardian for the express purpose of making health care treatment decisions, that guardian shall act as the patient's surrogate. If neither of these situations applies, the health care provider shall make reasonable efforts to contact the following individual or individuals in the indicated order of priority, who are available and willing to serve as the surrogate, who then have the authority to make health care decisions for the patient and who shall follow the patient's wishes if they are known: 1. The patient's spouse, unless the patient and spouse are legally separated. 2. An adult child of the patient. If the patient has more than one adult child, the health care provider shall seek the consent of a majority of the adult children who are reasonably available for consultation. 3. A parent of the patient. 4. If the patient is unmarried, the patient's domestic partner. 5. A brother or sister of the patient. 6. A close friend of the patient. B. If the health care provider cannot locate any of the people listed in subsection A of this section, the patient's attending physician may make health care treatment decisions for the patient after the physician consults with and obtains the recommendations of an institutional ethics committee. If this is not possible, the physician may make these decisions after consulting with a second physician who concurs with the physician's decision. C. A person who makes a good faith medical decision pursuant to this section is immune from liability to the same extent and under the same conditions as prescribed in section 36-3205. D. A surrogate may make decisions about mental health care treatment on behalf of a patient if the patient is found incapable. However, a surrogate who is not the patient's agent or guardian shall not make decisions to admit the patient to an inpatient psychiatric facility licensed by the department of health services, except as provided in subsection E of this section or section 14-5312.01, 14-5312.02 or 36-3281. E. If the admitting officer for a mental health care provider has reasonable cause to believe after examination that the patient is incapable as defined in section 36-3281 and is likely to suffer serious physical harm or serious illness or to inflict serious physical harm on another person without immediate hospitalization, the patient may be admitted for inpatient treatment in an inpatient psychiatric facility based on informed consent given by any surrogate identified in subsection A of this section. The patient shall be discharged if a petition for court ordered evaluation or for temporary guardianship requesting authority for the guardian to consent to admission to an inpatient psychiatric facility has not been filed within forty-eight hours of admission or on the following court day if the forty-eight hours expires on a weekend or holiday.
View on azleg.gov

This page provides general legal information about Arizona statutes and is not legal advice. For guidance on how this law applies to your situation, speak with a qualified attorney.

Related Questions

Who makes medical decisions if I do not have a power of attorney in Arizona?

Arizona law (A.R.S. 36-3231) creates a priority list: spouse, adult children (majority must agree), parent, domestic partner, sibling, then close friend. If no one is available, your doctor decides after consulting an ethics committee.

How do guardianship and conservatorship proceedings work in Arizona?

Both require filing with the Arizona Superior Court, medical evidence of incapacity, and a judge's approval. The process takes months and costs thousands. Powers of attorney accomplish the same goals without court involvement.

What is the difference between a Healthcare Power of Attorney and a Living Will?

A Healthcare Power of Attorney appoints someone to make medical decisions for you. A Living Will states your preferences for end-of-life treatment. Most estate plans include both documents.

Related Statutes

§ 36-3201Health Care Directive Definitions in Arizona
§ 36-3202How to Revoke a Health Care Directive in Arizona
§ 36-3203Surrogate Authority and Responsibilities for Health Care Decisions in Arizona

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